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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2021; 13(01): e51-e56
DOI: 10.1055/s-0041-1726288
Research Article

Follow-Up Rates at a Free Ophthalmology Clinic at a Homeless Shelter

Lauren Hennein 
1   Department of Ophthalmology, University of California San Francisco, San Francisco, California
,
Kimberly A. Spaulding
2   Department of Surgery, University of California San Francisco, San Francisco, California
,
Veronika Karlegan
3   Pre-Health Professions Certificate Program, San Francisco State University, San Francisco, California
,
Ogonna N. Nnamani Silva 
4   School of Medicine, University of California San Francisco, San Francisco, California
,
Alejandra G. de Alba Campomanes
5   Department of Ophthalmology, University of California San Francisco, San Francisco, California
› Institutsangaben
Funding This research was supported in part by an unrestricted grant from Research to Prevent Blindness, New York, NY. This study received its financial support from Research to Prevent Blindness http://dx.doi.org/10.13039/100001818.
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Abstract

Objective Eye health among the homeless community is important, as poor vision makes this population vulnerable and adds significantly to the social and health burden. There is limited knowledge on patient follow-up rates for their eye conditions and barriers to accessing care in this population. The purpose of this retrospective chart review study is to examine follow-up rates and barriers to care for patients referred from a free, medical-student run ophthalmology clinic at a homeless shelter.

Methods All patients evaluated at a free ophthalmology clinic from September 2017 to September 2018 were included; no patients were excluded. If indicated, patients were referred for advanced ophthalmologic care at a local county hospital and free eyeglasses at a nonprofit organization. Primary outcomes were follow-up rates at the county hospital and nonprofit organization. Secondary outcomes included prespecified baseline variables hypothesized to be associated with follow-up rates. These categorical variables were compared with Chi-square testing to determine their association with follow-up rates. The hypothesis being tested was formulated before data collection.

Results Of the 68 patients, 84% were males with a mean age of 50 years. Overall, 40 patients were referred for free eyeglasses and 17 to the county hospital. Of those referred, 14 patients presented for free eyeglasses and 7 presented to the county hospital. About 79% of patients with a pre-established primary care provider presented to their appointment compared with 20% of those without one (p = 0.03). The 44% of patients with a high school diploma presented while all patients without a high school diploma failed to present (p = 0.04). Vision-threatening conditions identified at the shelter clinic did not affect follow-up rates (p = 0.79).

Conclusion Less than half of referred patients in our study presented to their appointments. Barriers to presentation included no primary care provider and lower educational status, with no improvement in follow-up rates among those referred for vision-threatening conditions. Interventions such as health coaching with particular attention to educating patients on the effects of vision-threatening conditions may be warranted, particularly for those not looped into the health care system and those of lower educational attainment.

Keywords

homelessness - homeless shelter - free eye clinic - follow-up - medical student education


Publikationsverlauf

Eingereicht: 04. Mai 2020

Angenommen: 18. November 2020

Artikel online veröffentlicht:
24. März 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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